Orofacial Myofunctional Therapy for Obstructive Sleep Apnea: A Systematic Review and Meta-Analysis.
Level 1 - systematic review of randomized trials
Systematic review and meta-analysis of randomized controlled trials
PubMed 37606313 · doi:10.1002/lary.30974
What was done
A systematic review and meta-analysis following PRISMA guidelines searched PubMed/Medline, EMBASE, Cochrane, and Web of Science through March 24, 2023. The review evaluated randomized controlled trials assessing monotherapeutic orofacial myofunctional therapy in at least 10 obstructive sleep apnea patients compared to sham therapy or no therapy. The primary outcome was the apnea-hypopnea index; secondary outcomes were subjective sleepiness, sleep-related quality of life, minimum oxygen saturation, and snoring frequency.
What was found
Seven randomized controlled trials involving 310 patients met inclusion criteria. Adult patients receiving myofunctional therapy showed statistically significant improvements compared to controls: apnea-hypopnea index mean difference -10.2 (95% CI, -15.6 to -4.8, p < 0.05), Epworth Sleepiness Scale mean difference -5.66 (95% CI, -6.82 to -4.5, p < 0.05), Pittsburgh Sleep Quality Index mean difference -3.00 (95% CI, -4.52 to -1.49, p < 0.05), and minimum oxygen saturation mean difference 2.71 (95% CI, 0.23 to 5.18, p < 0.05). In the single pediatric trial, compliance was under 50% with no improvements observed in apnea-hypopnea index, minimum oxygen saturation, or snoring frequency.
Why it matters
Orofacial myofunctional therapy offers an evidence-backed alternative for adult obstructive sleep apnea patients unable to tolerate CPAP or other standard treatments.
Limits
The total sample size was small across only seven trials and 310 patients. Pediatric evidence was limited to a single trial with poor adherence. Long-term outcomes and real-world therapy compliance were not assessed.
Cited by
- partial Targeted exercises for the back of the throat and tongue muscles can dramatically open airways to resolve sleep apnea.